Pinto Diana, Ribeiro Branca Telles, Lopes Dantas Maria Tereza
Instituto de Psiquiatria--IPUB, Universidade Federal do Rio de Janeiro, RJ, Brazil.
Commun Med. 2005;2(2):177-88. doi: 10.1515/come.2005.2.2.177.
In the present article, we investigate the extent to which professional theories that underlie, inform, and guide the interviewing practices of two psychiatrists (a neuropsychiatrist and a psychoanalyst) are discursively displayed in their ways of conducting a psychiatric interview. This study analyses excerpts from two audio-recorded psychiatric interviews held at the Institute of Psychiatry of the Federal University of Rio de Janeiro. It follows theoretical and methodological frameworks derived from interactional sociolinguistics. Ethnographic data and research interviews with both clinicians also ground our discussion. Using frame analysis as a central tool, we found that the psychiatrist who subscribes to a neuropsychiatric orientation displays a concern on assessing the patient's cognitive processes, and shifts topics away from the patient's delusions to (re)introduce the institutional frame of the psychiatric interview. By contrast, the psychiatrist who holds a psychoanalytic orientation towards interviewing not only listens attentively to very personal topics introduced by the patient, but also sustains and develops these topics. Most of all, she proposes and stays within conversational frames. In keeping a dual understanding about their practices in the interview situation, both doctors balance the need to follow the institutional agenda and the need to listen to the patient, despite their different theoretical orientations.
在本文中，我们探讨了作为两位精神科医生（一位神经精神科医生和一位精神分析学家）访谈实践基础、依据并对其起到指导作用的专业理论，在他们进行精神科访谈的方式中是如何通过话语体现出来的。本研究分析了里约热内卢联邦大学精神病学研究所进行的两次精神科访谈的录音节选。它遵循了源自互动社会语言学的理论和方法框架。民族志数据以及对两位临床医生的研究访谈也为我们的讨论提供了依据。以框架分析作为核心工具，我们发现，秉持神经精神科取向的精神科医生关注评估患者的认知过程，并将话题从患者的妄想转移开，以（重新）引入精神科访谈的机构框架。相比之下，秉持精神分析取向进行访谈的精神科医生不仅会认真倾听患者提出的非常私人的话题，还会维持并拓展这些话题。最重要的是，她提出并停留在对话框架内。尽管两位医生的理论取向不同，但在对访谈情境中的实践保持双重理解的过程中，他们都在平衡遵循机构议程的需求和倾听患者的需求。
